Infarction of the ileocecal fold of Treves: a case of right lower quadrant pain.

The ileocecal fold of Treves is a peritoneal structure extending from the antimesenteric surface of the terminal ileum to the base of the appendix. No known pathologic conditions have been previously associated with it. We report a 30-year-old woman with acute onset of right lower quadrant pain. Her history was atypical for appendicitis. Endovaginal ultrasonography did not reveal gynecologic pathology. After a period of observation, the patient underwent diagnostic laparoscopy. This revealed inflammation and necrosis of the ileocecal fold of Treves and a normal-appearing appendix. The lesion was removed and appendectomy was performed. The patient's symptoms resolved immediately after surgery. Histopathologic examination of the lesion revealed fat necrosis, hemorrhagic necrosis, and lymphocytic infiltration. The appendix was normal. In conclusion, infarction of the ileocecal fold of Treves may be included in the differential diagnosis of right lower quadrant abdominal pain. Laparoscopy facilitates the diagnosis and treatment of unusual abdominal lesions.